Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration

Jung Hee Kim; Sung Eun Kim; Do Seon Song; Hee Yeon Kim; Eileen L. Yoon; Tae Hyung Kim; Young Kul Jung; Ki Tae Suk; Baek Gyu Jun; Hyung Joon Yim; Jung Hyun Kwon; Sung Won Lee; Seong Hee Kang; Moon Young Kim; Soung Won Jeong; Jae Young Jang; Jeong Ju Yoo; Sang Gyune Kim; Young Joo Jin; Gab Jin Cheon; Byung Seok Kim; Yeon Seok Seo; Hyung Su Kim; Dong Hyun Sinn; Woo Jin Chung; Hwi Young Kim; Han Ah Lee; Seung Woo Nam; In Hee Kim; Jung Il Suh; Ji Hoon Kim; Hee Bok Chae; Joo Hyun Sohn; Ju Yeon Cho; Yoon Jun Kim; Jin Mo Yang; Jung Gil Park; Won Kim; Hyun Chin Cho; Dong Joon Kim

doi:10.3390/jcm11092463

Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration

Jung Hee Kim, Sung Eun Kim, Do Seon Song, Hee Yeon Kim, Eileen L. Yoon, Tae Hyung Kim, Young Kul Jung, Ki Tae Suk, Baek Gyu Jun, Hyung Joon Yim, Jung Hyun Kwon, Sung Won Lee, Seong Hee Kang, Moon Young Kim, Soung Won Jeong, Jae Young Jang, Jeong Ju Yoo, Sang Gyune Kim, Young Joo Jin, Gab Jin CheonByung Seok Kim, Yeon Seok Seo, Hyung Su Kim, Dong Hyun Sinn, Woo Jin Chung, Hwi Young Kim, Han Ah Lee, Seung Woo Nam, In Hee Kim, Jung Il Suh, Ji Hoon Kim, Hee Bok Chae, Joo Hyun Sohn, Ju Yeon Cho, Yoon Jun Kim, Jin Mo Yang, Jung Gil Park, Won Kim, Hyun Chin Cho, Dong Joon Kim

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.

Original language	English
Article number	2463
Journal	Journal of Clinical Medicine
Volume	11
Issue number	9
DOIs	https://doi.org/10.3390/jcm11092463
State	Published - 1 May 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

acute decompensation
acute-on-chronic liver failure
adverse outcomes
liver cirrhosis
platelet-to-white blood cell ratio

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10.3390/jcm11092463

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Kim, J. H., Kim, S. E., Song, D. S., Kim, H. Y., Yoon, E. L., Kim, T. H., Jung, Y. K., Suk, K. T., Jun, B. G., Yim, H. J., Kwon, J. H., Lee, S. W., Kang, S. H., Kim, M. Y., Jeong, S. W., Jang, J. Y., Yoo, J. J., Kim, S. G., Jin, Y. J., ... Kim, D. J. (2022). Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration. Journal of Clinical Medicine, 11(9), Article 2463. https://doi.org/10.3390/jcm11092463

@article{5459ed93b42e42929bef4a768766c647,

title = "Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration",

abstract = "Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.",

keywords = "acute decompensation, acute-on-chronic liver failure, adverse outcomes, liver cirrhosis, platelet-to-white blood cell ratio",

author = "Kim, {Jung Hee} and Kim, {Sung Eun} and Song, {Do Seon} and Kim, {Hee Yeon} and Yoon, {Eileen L.} and Kim, {Tae Hyung} and Jung, {Young Kul} and Suk, {Ki Tae} and Jun, {Baek Gyu} and Yim, {Hyung Joon} and Kwon, {Jung Hyun} and Lee, {Sung Won} and Kang, {Seong Hee} and Kim, {Moon Young} and Jeong, {Soung Won} and Jang, {Jae Young} and Yoo, {Jeong Ju} and Kim, {Sang Gyune} and Jin, {Young Joo} and Cheon, {Gab Jin} and Kim, {Byung Seok} and Seo, {Yeon Seok} and Kim, {Hyung Su} and Sinn, {Dong Hyun} and Chung, {Woo Jin} and Kim, {Hwi Young} and Lee, {Han Ah} and Nam, {Seung Woo} and Kim, {In Hee} and Suh, {Jung Il} and Kim, {Ji Hoon} and Chae, {Hee Bok} and Sohn, {Joo Hyun} and Cho, {Ju Yeon} and Kim, {Yoon Jun} and Yang, {Jin Mo} and Park, {Jung Gil} and Won Kim and Cho, {Hyun Chin} and Kim, {Dong Joon}",

note = "Publisher Copyright: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2022",

month = may,

day = "1",

doi = "10.3390/jcm11092463",

language = "English",

volume = "11",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "9",

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Kim, JH, Kim, SE, Song, DS, Kim, HY, Yoon, EL, Kim, TH, Jung, YK, Suk, KT, Jun, BG, Yim, HJ, Kwon, JH, Lee, SW, Kang, SH, Kim, MY, Jeong, SW, Jang, JY, Yoo, JJ, Kim, SG, Jin, YJ, Cheon, GJ, Kim, BS, Seo, YS, Kim, HS, Sinn, DH, Chung, WJ, Kim, HY, Lee, HA, Nam, SW, Kim, IH, Suh, JI, Kim, JH, Chae, HB, Sohn, JH, Cho, JY, Kim, YJ, Yang, JM, Park, JG, Kim, W, Cho, HC & Kim, DJ 2022, 'Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration', Journal of Clinical Medicine, vol. 11, no. 9, 2463. https://doi.org/10.3390/jcm11092463

TY - JOUR

T1 - Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration

AU - Kim, Jung Hee

AU - Kim, Sung Eun

AU - Song, Do Seon

AU - Kim, Hee Yeon

AU - Yoon, Eileen L.

AU - Kim, Tae Hyung

AU - Jung, Young Kul

AU - Suk, Ki Tae

AU - Jun, Baek Gyu

AU - Yim, Hyung Joon

AU - Kwon, Jung Hyun

AU - Lee, Sung Won

AU - Kang, Seong Hee

AU - Kim, Moon Young

AU - Jeong, Soung Won

AU - Jang, Jae Young

AU - Yoo, Jeong Ju

AU - Kim, Sang Gyune

AU - Jin, Young Joo

AU - Cheon, Gab Jin

AU - Kim, Byung Seok

AU - Seo, Yeon Seok

AU - Kim, Hyung Su

AU - Sinn, Dong Hyun

AU - Chung, Woo Jin

AU - Kim, Hwi Young

AU - Lee, Han Ah

AU - Nam, Seung Woo

AU - Kim, In Hee

AU - Suh, Jung Il

AU - Kim, Ji Hoon

AU - Chae, Hee Bok

AU - Sohn, Joo Hyun

AU - Cho, Ju Yeon

AU - Kim, Yoon Jun

AU - Yang, Jin Mo

AU - Park, Jung Gil

AU - Kim, Won

AU - Cho, Hyun Chin

AU - Kim, Dong Joon

PY - 2022/5/1

Y1 - 2022/5/1

N2 - Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.

AB - Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.

KW - acute decompensation

KW - acute-on-chronic liver failure

KW - adverse outcomes

KW - liver cirrhosis

KW - platelet-to-white blood cell ratio

UR - http://www.scopus.com/inward/record.url?scp=85129010580&partnerID=8YFLogxK

U2 - 10.3390/jcm11092463

DO - 10.3390/jcm11092463

M3 - Article

AN - SCOPUS:85129010580

SN - 2077-0383

VL - 11

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 9

M1 - 2463

ER -

Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration

Abstract

Bibliographical note

Keywords

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